---
kind: "section"
citation: "42 C.F.R. § 460.64"
title: "42"
number: "460.64"
heading: "Personnel qualifications for staff with direct participant contact."
url: "https://uscodex.org/cfr/42/460.64"
---

# §460.64. Personnel qualifications for staff with direct participant contact.

- (a) **General qualification requirements.** Each member of the PACE organization's staff (employee or contractor) that has direct contact with participants must meet the following conditions:
  - (1) Be legally authorized (for example, currently licensed, registered or certified if applicable) to practice in the State in which he or she performs the function or action;
  - (2) Only act within the scope of his or her authority to practice;
  - (3) Have 1 year of experience working with a frail or elderly population or, if the individual has less than 1 year of experience but meets all other requirements under [paragraph (a)](#a) of this section, must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.
  - (4) Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.
  - (5) **Be medically cleared for communicable diseases before engaging in direct participant contact.**
    - (i) Staff must be cleared for communicable diseases based on a physical examination performed by a licensed physician, nurse practitioner, or physician assistant acting within the scope of their authority to practice, unless—
      - (A) The PACE organization conducts an individual risk assessment that meets the conditions specified in [paragraph (a)(5)(iii)](#a-5-iii) of this section; and
      - (B) The results of the risk assessment indicate the individual does not require a physical examination for medical clearance.
    - (ii) As part of the initial physical examination, staff must be determined to be free of active Tuberculosis disease.
    - (iii) If the PACE organization conducts a risk assessment on an individual under paragraphs [(a)(5)(i)(A)](#a-5-i-A) and [(B)](#a-5-i-B) of this section—
      - (A) Policies and procedures for conducting a risk assessment on each individual with direct participant contact must be based on accepted professional standards of care;
      - (B) The PACE organization's risk assessment must identify when a physical examination is required based on the results of the assessment; and
      - (C) The results of the risk assessment must be reviewed by a registered nurse, physician, nurse practitioner, or physician assistant.
      - (D) At a minimum, the risk assessment must do both of the following:

        (1) Assess whether staff have been exposed to or have any symptoms of the following diseases:

        (i) COVID-19.

        (ii) Diphtheria.

        (iii) Influenza.

        (iv) Measles.

        (v) Meningitis.

        (vi) Meningococcal Disease.

        (vii) Mumps.

        (viii) Pertussis.

        (ix) Pneumococcal Disease.

        (x) Rubella.

        (xi) Streptococcal Infection.

        (xii) Varicella Zoster Virus.

        (xiii) Any other infectious diseases noted as a potential threat to public health by the CDC.

        (2) Determine if staff are free of active Tuberculosis during the initial risk assessment.

  - (6) **Have all immunizations up to date before engaging in direct participant contact.**
- (b) **Federally-defined qualifications for physician.** In addition to the qualification specified in [paragraph (a)](#a) of this section, a physician must meet the qualifications and conditions in [§ 410.20](/cfr/42/410.20.md) of this chapter.

## Notes

### Amendments

[71 FR 71334, Dec. 8, 2006, as amended at 84 FR 25673, June 3, 2019; 89 FR 30844, Apr. 23, 2024]

### Authority

Authority: 42 U.S.C. 1302, 1395, 1395eee(f), and 1396u-4(f).

### Source

Source: 64 FR 66279, Nov. 24, 1999, unless otherwise noted.

### Amendments

[71 FR 71334, Dec. 8, 2006, as amended at 84 FR 25673, June 3, 2019; 89 FR 30844, Apr. 23, 2024]